title: Damage control operation for massive sacrococcygeal teratoma.
abstract: Surgical resections of massive sacrococcygeal teratomas (SCTs) carry significant risk due to baseline hemodynamic instability and the potential for significant hemorrhage. In this case report, a fetus with sacrococcygeal teratoma developed high-output cardiac instability at 32 weeks' gestation. After urgent cesarian delivery, a damage-control operation using Teflon-pledgeted mattress sutures allowed for hemodynamic control of bleeding into the tumor. One week later, after subsequent fluid resuscitation and stabilization, an elective staged resection of the complete mass including the pelvic portion was performed. The patient was discharged home on postoperative day 30 and was doing well at her most recent clinic visit at 30 months of age.
authors.affiliation: Department of Surgery, Children's Hospital Boston, Boston, MA 02115, USA.
authors.forename: C Jason
authors.initials: CJ
authors.lastname: Smithers
authors.forename: Patrick J
authors.initials: PJ
authors.lastname: Javid
authors.forename: Christopher G
authors.initials: CG
authors.lastname: Turner
authors.forename: Justin D
authors.initials: JD
authors.lastname: Klein
authors.forename: Russell W
authors.initials: RW
authors.lastname: Jennings
mesh_terms: D016534:Cardiac Output, High / Q000196:embryology / Q000209:etiology; D002585:Cesarean Section; D004200:Diseases in Twins; D004630:Emergencies; D005260:Female; D005307:Fertilization in Vitro; D005440:Fluid Therapy; D005865:Gestational Age; D006470:Hemorrhage / Q000196:embryology / Q000209:etiology / Q000601:surgery; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000379:methods*; D012445:Sacrococcygeal Region; D012983:Soft Tissue Neoplasms / Q000098:blood supply / Q000150:complications / Q000196:embryology / Q000601:surgery*; D013536:Suture Techniques; D013724:Teratoma / Q000098:blood supply / Q000150:complications / Q000196:embryology / Q000601:surgery*; D047368:Tumor Burden